Thank you for your interest in our Head Start Preschool Program! As you complete the online pre-application, please take your time and fill out each section with the requested information. If you have questions or need help at any point, our team is happy to support you. Please call us at 719-420-0125.
Parent/Guardian
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender (Required)
Female
Male
Non-Binary
Email Address (Required)
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Prefer not to answer
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chinese
English
German
Hindi
Other
Spanish
Tagalog
Other Language Proficiency
Little
Moderate
None
Proficient
Child's Relationship (Required)
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Address
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Click here
to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Non-Binary
Email Address
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Prefer not to answer
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chinese
English
German
Hindi
Other
Spanish
Tagalog
Other Language Proficiency
Little
Moderate
None
Proficient
Child's Relationship (Required)
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Family Information
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
American Sign Language
Chinese
English
German
Hindi
Other
Spanish
Tagalog
Is another language being acquired or learned at home?
Yes
No
Number in Family
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Is at least one parent/guardian an active duty member of the United States military?
Yes
No
Is at least one parent/guardian a veteran of the United States military?
Yes
No
Emergency Contacts
Add Emergency Contact
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Non-Binary
Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Lives with Family
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chinese
English
German
Hindi
Other
Spanish
Tagalog
Other Language Proficiency
Little
Moderate
None
Proficient
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Location Preferences
Which program are you applying for? (Required)
2026-2027 Pueblo & Pueblo West
Preschool for Children Ages 3 to 5
2026-2027 Walsenburg
Preschool for Children Ages 3 to 5
2026-2027 Trinidad
Preschool for Children Ages 3 to 5
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd Location Preference
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- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Siblings
Are there other children in the family?
Add a Sibling
Thank you for submitting your child’s pre-application for our Head Start Preschool Program! To help us determine if your child qualifies for Head Start, we will need to review proof of your child’s age and your family’s income. You may upload or gather documents such as proof of your child’s age (birth certificate or immunization record) and proof of benefits like SNAP, TANF, or SSI, or proof of income (1040 tax form, W-2s, or pay stubs). If you’re not sure what documents to provide or if these don’t apply to your family, a Family Service Engagement Worker will guide you through what is needed. A Family Service Engagement Worker will call you within 3–5 business days to schedule an appointment to complete the full application. During this appointment, they will review your information, gather any needed documents, and answer your questions. If you need assistance right away or have questions before we contact you, please call us at 719-420-0125.
Required information is missing, see above.